Public opinion regarding tattooing and piercing is changing as well, particularly among those aged younger than 50 years. However, societal acceptance doesn’t mean there aren’t consequences for body modification. The report reveals that employers still cite tattoos as a limitation when it comes to career potential, and adolescents should be counseled about the visibility and potential consequences later in life of their body modification choices.
The report also reveals that although most teenagers and young adults are aware of the risk of contracting human immunodeficiency virus from tattooing and/or piercing, less were aware of the risks of hepatitis and tetanus or noninfectious medical complications.
The report details the processes used for tattooing, as well as the recommended care of new tattoos. Pediatricians and parents should be aware that although the process for tattooing is generally safe, many tattoos are done by amateurs who may not follow antiseptic procedures, therefore increasing the risk of complications. In addition to infectious complications, tattoos can result in inflammation, neoplasms, and even vasculitis. Preexisting conditions such as psoriasis, systemic lupus, and sarcoidosis may activate the Koebner phenomenon, leading to new lesions at the site of the tattoo. Still, infections are the more serious complication of tattooing, and can be caused by contaminated ink or needles, or contamination or injured tissue during the healing process.
For individuals who don’t experience complications but later regret a tattoo, removal is an option, but it is both expensive and painful.
In regard to piercing, there are also concerns about infection. Body piercing salons are unregulated in many states and ear piercing guns are generally not sterilized between uses. For this reason, some physicians may choose to perform body piercing in the clinical setting. Popular choices for body piercings include ears, cartilage, nose and septum, navel, lips, cheeks, the tongue, and dermal piercing. Attention must be paid to the location of the piercing and the appropriate jewelry type to avoid complications during the healing process.
Similar to tattooing, piercing carries a risk of infection ranging from local to severe to life threatening. Bloodborne pathogens can be transmitted, and infection can also result from poor sanitation during the piercing or healing process. Individuals with atopic dermatitis or allergic metal contact dermatitis are at increased risk of developing staphylococcal or streptococcal skin infections.
Generally, the clinical report cautions pediatricians to assess adolescents and young adults interested in body modification for NSSI syndrome, and to educate them on the possible significant consequences both for their health and future career. Teenagers and their parents should be reminded that tattoos are permanent, and that removal may not be entirely effective in addition to being painful and expensive. Education should be provided on finding safe, clean locations for tattooing and piercing, as well as the risks of possible scarring and/or medical complications. Pediatricians should also counsel teenagers and their parents about when to seek medical attention in the event of a complication, and how to care for new tattoos or piercings.
“Healthcare providers, parents, and young adults considering tattoos or piercing need to be aware that there are risks and that they should be prepared with up-to-date immunizations,” says Breuner. “They should also be knowledgeable about complications and contraindications including if they have immunodeficiency disease.”